Devices, systems, and methods for use in connection with umbilical hernias

ABSTRACT

A device for treatment of an umbilical hernia includes a first section of flexible, elastic material including an adhesive layer on rearward side thereof. The first section includes an opening therein dimensioned to encompass the umbilical. The device further includes a plurality of extending sections of flexible, elastic material attached to and extending from the first section. Each of the extending sections includes an adhesive layer on a rearward side thereof. The first section is less elastic than each of the plurality of extending sections.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims benefit of U.S. Provisional Patent ApplicationSer. No. 63/171,664, filed Apr. 7, 2021, the disclosure of which isincorporated herein by reference.

BACKGROUND

The following information is provided to assist the reader inunderstanding technologies disclosed below and the environment in whichsuch technologies may typically be used. The terms used herein are notintended to be limited to any particular narrow interpretation unlessclearly stated otherwise in this document. References set forth hereinmay facilitate understanding of the technologies or the backgroundthereof. The disclosure of all references cited herein are incorporatedby reference.

Umbilical hernias are one of the most common pediatric surgicalconditions affecting 20-30% of infants during their first year of life.This number is even higher in those children who are born premature orhave altered muscle tone. An umbilical hernia leaves the child with agap in their core musculature through which their abdominal contents(intestines and fluid) will protrude. During a time of such significantgrowth and development, it is problematic that the suggested treatmentfor these types of hernias is a “wait and see” approach to see if thehernia closes before the child is 3 years old. At 3 years old,anesthesia and surgical correction becomes a safer option if a herniahas not closed by itself. As a result, it can be up to 3 years of worryfor a parent, and months to years of development where the child's coreis weaker than it needs to be.

A number of studies address umbilical hernia with the use of elastictape applied to the child's abdomen. For example, Clinic Notes fromPoland and the Netherlands describes a uniplanar and basic muscleapproximation to improve appearance of umbilical hernias with elastickinesiology tape that comes in a 2-inch width roll and is cut by eachclinician. Nothing is pre-fabricated. Licensed and trained physicaltherapist, not parents, perform the applications of the kinesiology tapeto the child's abdomen.

A product from Kinesio Light includes a 2-inch or 1-inch roll of tapethat each clinician can cut to use for a variety of reasons such asmuscle activation, lymphedema control, or stability. Once again, nothingis prefabricated for infants. The product is sold as a roll and aclinician cuts and applies each length of tape. The tape is appliedevery three days.

Umbilical hernia belts are also available for use with infants that wrapcircumferentially around the infant's stomach to decrease protrusion ofthe hernia. However, such belts can impede the natural pattern ofbreathing, impede the natural movement, and can be uncomfortable.Moreover, umbilical hernia belts do not promote natural healing.

Adults also experience umbilical hernias. In general, umbilical herniasin adults are less likely heal on their own than umbilical hernias ininfants. Umbilical hernias in adults typically grow larger over time andmay require surgical repair. Umbilical hernias are, for example, commonduring pregnancy. Treatments for umbilical hernias in adults arelimited.

SUMMARY

In one aspect, a device for treatment of an umbilical hernia includes afirst section of flexible, elastic material including an adhesive layeron rearward side thereof. The first section includes an opening thereindimensioned to encompass the umbilical. The device further includes aplurality of extending sections of flexible, elastic material attachedto and extending from the first section. Each of the plurality ofextending sections includes an adhesive layer on a rearward sidethereof. The first section is less elastic than each of the plurality ofextending sections in a number of embodiments. The device may furtherinclude one or more removable backing sections or layers over theadhesive layer of the first section and over each of the plurality ofextending sections.

In a number of embodiments, a first plurality of the extending sectionsextend from a first side of the first section and a second plurality ofthe extending sections extend from a second side of the first section.In a number of embodiments, the first plurality of extending sectionsand the second plurality of extending sections have a maximum elongationin the range of 25 to 150%, in the range of 25 to 100% or in the rangeof 50 to 100%. The maximum elongation of the first section is in therange of 15 to 85% less than the maximum elongation of the extendingsections in a number of embodiments. In a number of embodiments, thefirst section has a thickness greater than each of the plurality ofextending sections.

In a number of embodiments, kinesiology tape is used in the devices,systems, and method hereof. In a number of embodiments, the elasticmaterials used herein may have material properties that are similar toor mimic those of human skin. In general, the material properties of theelastic materials used in the devices, systems, and method hereof canvary over a relatively broad range while accomplishing the objects setforth herein. The material properties (for example, elasticity andmaximum elongation) of each of the first section and the second sectionof device hereof may be predetermined at the time of manufacture.

In another aspect, a method of treating an umbilical hernia includesproviding a preassembled device including a first section of flexible,elastic material which includes an adhesive layer on rearward sidethereof. The first section also includes an opening therein dimensionedto encompass the umbilical. The preassembled device further includes aplurality of extending sections of flexible, elastic material attachedto and extending from the first section. Each of the plurality ofextending sections includes an adhesive layer on a rearward sidethereof. The first section is less elastic than each of the plurality ofextending sections. The first section of the preassembled device isapplicable to the abdomen of an individual (for example, the abdomen ofa child) having the umbilical hernia, and each of the plurality ofextending sections of flexible, elastic material is applicable to theabdomen. In a number of embodiments, the first section is less elasticthan each of the plurality of extending sections. The method may furtherinclude removing one or more removable backing layers or sections overthe adhesive layer of the first section and over each of the pluralityof extending sections before applying the first section and each of theplurality of extending sections to the patient.

As described above, in a number of embodiments, a first plurality of theextending sections extend from a first side of the first section and asecond plurality of the extending sections extend from a second side ofthe first section. In a number of embodiments, the first plurality ofextending sections and the second plurality of extending sections have amaximum elongation in the range of 25 to 150%, in the range of 25 to100% or in the range of 50 to 100%. The maximum elongation of the firstsection is in the range of 15 to 85% less than the maximum elongation ofthe extending sections in a number of embodiments. In a number ofembodiments, the first section has a thickness greater than each of theplurality of extending sections. A plurality of the devices may beprovided.

In a further aspect, a kit includes a plurality of devices for treatmentof an umbilical hernia which are prefabricated for application. Each ofthe devices includes a first section of flexible, elastic materialcomprising an adhesive layer on rearward side thereof. The first sectionincludes an opening therein dimensioned to encompass the umbilical. Eachdevice further includes a plurality of extending sections of flexible,elastic material attached to and extending from the first section. Eachof the plurality of extending sections include an adhesive layer on arearward side thereof. The first section is less elastic than each ofthe plurality of extending sections. Each of the devices may furtherinclude one or more removable backing sections or layers over theadhesive layer of the first section and over each of the plurality ofextending sections.

As described above, in a number of embodiments, a first plurality of theextending sections extend from a first side of the first section of eachdevice and a second plurality of the extending sections extend from asecond side of the first section of each device. In a number ofembodiments, the first plurality of extending sections and the secondplurality of extending sections have a maximum elongation in the rangeof 25 to 150%, in the range of 25 to 100% or in the range of 50 to 100%.The maximum elongation of the first section of each device may, forexample, be in the range of 15 to 85% less than the maximum elongationof the extending sections in a number of embodiments. In a number ofembodiments, the first section of each device has a thickness greaterthan each of the plurality of extending sections.

The present devices, systems, and methods, along with the attributes andattendant advantages thereof, will best be appreciated and understood inview of the following detailed description taken in conjunction with theaccompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates the abdominal muscle anatomy.

FIG. 2 illustrates an umbilical hernia.

FIG. 3 illustrates the layers of tissue overlying the intestines in theabdomen.

FIG. 4A illustrates a top plan view of an embodiment of a device orsystem.

FIG. 4B illustrates a bottom plan view of the embodiment of FIG. 4A withextending sections extending from the first section at an angle.

FIG. 4C illustrates a side view of the embodiment of FIG. 4A.

FIG. 4D illustrates an embodiment of the device or system of FIG. 4Aapplied to an infant's abdomen.

FIG. 5 illustrates a bottom plan view of an embodiment of a device orsystem hereof; wherein representative dimensions are provide in inches.

FIG. 6 illustrates a top plan view of the device of FIG. 5 in adisconnected or disassembled state; wherein representative dimensionsare provide in inches.

FIG. 7A illustrates a top plan view of a kit including a plurality ofdevices hereof within packaging.

FIG. 7B illustrates a side view of the kit of FIG. 7A.

DETAILED DESCRIPTION

It will be readily understood that the components of the embodiments, asgenerally described and illustrated in the figures herein, may bearranged and designed in a wide variety of different configurations inaddition to the described representative embodiments. Thus, thefollowing more detailed description of the representative embodiments,as illustrated in the figures, is not intended to limit the scope of theembodiments, as claimed, but is merely illustrative of representativeembodiments.

Reference throughout this specification to “one embodiment” or “anembodiment” (or the like) means that a particular feature, structure, orcharacteristic described in connection with the embodiment is includedin at least one embodiment. Thus, the appearance of the phrases “in oneembodiment” or “in an embodiment” or the like in various placesthroughout this specification are not necessarily all referring to thesame embodiment.

Furthermore, described features, structures, or characteristics may becombined in any suitable manner in one or more embodiments. In thefollowing description, numerous specific details are provided to give athorough understanding of embodiments. One skilled in the relevant artwill recognize, however, that the various embodiments can be practicedwithout one or more of the specific details, or with other methods,components, materials, et cetera. In other instances, well knownstructures, materials, or operations are not shown or described indetail to avoid obfuscation.

As used herein and in the appended claims, the singular forms “a,” “an”,and “the” include plural references unless the context clearly dictatesotherwise. Thus, for example, reference to “an extending length of tape”includes a plurality of such extending lengths of tape and equivalentsthereof known to those skilled in the art, and so forth, and referenceto “the extending length of tape” is a reference to one or more suchextending length of tape and equivalents thereof known to those skilledin the art, and so forth. Recitation of ranges of values herein aremerely intended to serve as a shorthand method of referring individuallyto each separate value falling within the range. Unless otherwiseindicated herein, and each separate value, as well as intermediateranges, are incorporated into the specification as if individuallyrecited herein. All methods described herein can be performed in anysuitable order unless otherwise indicated herein or otherwise clearlycontraindicated by the text.

Although a number of representative embodiments hereof are discussed foruse with infants, one skilled in the art will appreciate that thedevices, systems, and methods hereof may also be used in connection withumbilical hernias in older children and in adults. In general, thedesign and functionality of the devices, systems, and method hereofdiffers little between use in connection with infants, children, andadult. Typically, only the size of the device or system is changed. Inthe case of used of the devices, systems, and method hereof inconnection with adults (for example, in connection with pregnant women)the goal may often be more of maintenance (that is, preventing anumbilical hernia from worsening) rather than healing the hernia.

The devices, systems, and methods hereof provide a safe, non-surgical,prefabricated, and user/parent friendly way to improve the appearance ofthe belly button area and medical outcome for those with an umbilicalhernia. The devices, systems, and methods hereof assist the muscles toapproximate together and decrease the size of the gap between themuscles, which also may improve ability to stabilize and activate coremuscles. The safe and parent- or user-friendly systems hereof can helpavoid an unnecessary surgery and can result in improvement within about30 days in the case of infants. In general, the sooner the problem isaddressed, the faster the results.

The devices and system hereof help in approximating the rectus abdominalmuscles to promote umbilical hernia closure, while not restrictingage-appropriate belly breathing. Further, the devices and system hereofimprove the overall appearance of the belly button area of the infant ortoddler with an umbilical hernia. The devices and systems hereof promoteproper muscle alignment to promote age-appropriate strength anddevelopment. Moreover, the devices and system hereof may be used toavoid expensive and unnecessary surgery later in life as a result ofpersistence of an umbilical hernia.

FIG. 1 illustrates typical abdominal muscle anatomy, as seen from thefrontal view. There are three main classifications of muscles that makeup the core. First, the rectus abdominus run vertically alongside theumbilicus to flex the stomach as during a sit up. Second, the internaland external obliques run at opposite diagonals (like an X) towards themiddle of the stomach which allow for rotation type movements of thecore. Further, the transverse abdominus muscle wraps completely aroundthe lower stomach and back to form a corset, providing stability andprotection to the core. An umbilical hernia pierces through all of thesemuscles to create a hole where the belly button is typically located,disrupting the stability, protection, and movement functions of all ofthese muscles, as illustrated in FIG. 2. As a result of this weakness inthe system, abdominal contents push out into the hernial sac, which isalso depicted in the side view of FIG. 2. FIG. 3 illustrates the layersof tissue overlying the intestines in the area of the abdomen.

The devices and systems described herein may, for example, assist inclosure of an umbilical hernia in infants and reduce discomfort fromprotruding hernial sac. The devices and systems hereof are non-invasive,safe, and prefabricated. The prefabricated systems and devices hereofprovide a parent-friendly way to help bring the abdominal musclestogether and promote self-healing of the weakened portion of theabdominal wall. The devices and systems hereof also promote the naturalrhythm of the manner in which a baby belly-breathes and moves by beingflexible and non-circumferential (that is, not extending around theentire waist of the child). The umbilicus is not occluded which promotesproper cleaning and aeration of the umbilical skin area. Covering theumbilicus can provide a source of infection or bacteria. In a number ofembodiments, the devices and systems hereof are water resistant, so thatthe baby can be bathed as they normally would while still wearing thedevice. Furthermore, the device can be removed easily and withoutdiscomfort to the child by, for example, applying baby oil or lotion(such as typically used in infant skin care) to the area prior toremoval.

An embodiment of a device or system 10 hereof suitable for use withinfants, older children and, adults is illustrated in FIGS. 4A through4D. In a number of embodiments, device 10 is formed of a therapeuticadhesive tape such as a non-latex based elastic cotton tape that isflexible. In general, the tension applied by such therapeutic tape canbe adjusted by the amount or percentage of stretching duringapplication. Device 10 includes a first section 20 having a passage oropening 22 formed therein. In a number of embodiments for use inconnection with infants, first section 20 was approximately 2 inches(5.08 cm; in an unstretched state) in width and opening 22 issufficiently wide to be able to encompass a mild to moderate hernia andassociated tented skin to be treated. A plurality of extending sectionsor lengths of tape 30 are formed integrally with the first section 20and extend laterally therefrom. Extending sections 30 may be applieddiagonally (or extending at an angle) from first section 20. In a numberof studied embodiments for use in connection with infants, extendingsections 30 were approximately 1 inch (2.54 cm) in width andapproximately 2 to 2.5 inches (5.08 to 6.35 cm; in an unstretched state)in length.

In a number of embodiments, extending sections 30 can range 0.5 inches(1.27 cm) and 1 inch (2.54 cm) in width. Based on clinical experience,irritation to the skin typically increases with increasing tape width.However, tape having a width less than 0.5 inch (1.27 cm) typicallybecome very difficult to use and often become twisted on itself.

The material properties of such tapes are, for example, described inBoonkerd, C. and Limroongreungrat, W., Elastic therapeutic tape: do theyhave the same material properties?, J. Phys. Ther. Sci. 28: 1303-1306,2016, the disclosure of which is incorporated herein by reference.Elastic therapeutic tapes such as used in extending sections 30typically provide a maximum elongation in the range of approximately 50to 150%.

In a number of embodiments, the elasticity of first section 20 ofadhesive elastic tape is less than the elasticity of extending sections30 and first section 20 is more difficult to stretch than extendingsections 30. In a number of embodiments, first section 20, which ispositioned around the navel upon application, is thicker and/or providesless elasticity/stretchability of the tape itself. For example, firstsection 20 may be formed from a double layer of the tape (for example,kinesiology tape) that is used in forming extending sections 30.Additionally or alternatively, one may make first section 20 longerand/or apply an elastic layer thereto by spraying, stamping, orpainting. For example, a layer of silicon or other elastic material canbe applied over the area of first section 20. In general, the componentsof the first section are integrally formed at the time of manufacture.First section 20 may, for example, be 15% to 85% less elastic orstretchable than extending sections 30. The properties of first section20 assist in the application of device 10 and to provide the stabilityneeded to approximate the left and right rectus abdominis muscles. Suchproperties reduce the difficulty in applying device 10 to help enableparents (or other users) to apply device 10 without the assistance of atherapist in applying the varied tension of the adhesive tape of device10 in a manner that is optimal to achieve the best results. The variedtension is built into device 10.

In a number of studied embodiments in which extending sections 30 wereapproximately 2 inches (5.08 cm) in length, the maximum stretched lengthof extending sections 30 was approximately 8 cm, providing a maximumelongation of 60%. First section 20 had an initial length ofapproximately 5.08 cm and exhibited a maximum stretched length of 7 cm,corresponding to a maximum elongation of 40%. In the studiedembodiments, each of extending sections 30 were formed from a single,continuous layer of therapeutic adhesive tape, and first section 20included a second layer of the therapeutic adhesive tape used inextending sections 30 and overlaid upon the layer of therapeutic tapeforming extending sections 30. The two layers of therapeutic adhesivetape of first section 20 were oriented in a parallel (fiber) direction.If the second layer of first section 20 were oriented perpendicular tothe first layer, the elasticity would be even further reduce(potentially to approximately 0). However, if the fibers of the tape arealigned in a cross or perpendicular pattern, air flow may be reducedexcessively. Moreover, it is desirable to provide some elasticity infirst section 20. Once again, however, the elasticity (maximumelongation) of first section 20 should be reduced compared extendingsections 30.

The elastic properties of the lateral/diagonal extending sections 30 ofadhesive tape provide more elasticity or stretchability as describedabove. The increased stretchability extending sections 30 of device 10promotes muscle activation of the oblique and transverse abdominusmuscle fibers by their connection to the skin via fascial layers (seeFIG. 3) and gentle gliding of those layers as the infant moves andcontracts his or her muscles naturally. Device 10 is non-invasive and isnot chemically or electrically stimulating the muscles.

To apply device 10, one or more sections of paper backing or backinglayer(s) 40 (see FIGS. 4A through 4C and 5), which covers and protectsan adhesive layer, is/are first removed in the intermediately positionedfirst section 20, and first section 20 is applied gently around theherniated area. Then, paper backing 40 can be removed from eachextending section 30, and each extending section 30 can be applied at avariety of angles (relative to first section 20, which are adjustableupon application) to promote activation of the lateral trunk muscles(internal and external obliques). Extending sections 30 may be appliedgently with little to no stretching of tape needed during theapplication. Clinically, in a number of embodiments, a 10-20% stretch ofeach of first section 20 and extending sections 30 is suitable. Thisapplication method will allow the tape to stretch with the infant as itmoves and breathes. The flexibility of the adhesive tape material allowsextending sections 30 to be placed in a variety of functional positionsand to decrease any potential skin irritation (via positional variation)with continued use. Device 10 is illustrated in FIG. 4D applied to athree-month old infant with an umbilical hernia (1^(st) application). Inthe illustrated embodiment, two laterally/diagonally extending sections30 are provided on each side of first section 20. However, the number ofextending sections 30 on each side may vary independently. In a numberof embodiments, two to four extending sections 30 are provided on eachside of first section 20.

In the embodiment illustrated in FIG. 5, paper backing or backing layer40 a of device 10 a is formed in two sections with a slit 42 apositioned under first section 20 a (illustrated in dashed lines in FIG.5) and separating backing layer 40 a into two backing layer sections.During application, the person applying device 10 a can peel backinglayer 40 a from underneath first section 20 a and apply that portion ofdevice 10 a to the patient with opening 22 a positioned around theumbilical hernia. The remainder of each section of backing layer 40 acan then be removed to adhere extending sections 30 a to the patient. Inother embodiments, two slits are provided in a paper backing or backinglayer, wherein one slit is positioned on each side of opening 22 a. Suchslits may, for example, be positioned laterally at the approximateposition wherein extending sections 30 meet first section 20.

FIG. 6 illustrates device 10 a of FIG. 5 in a disassembled state showinga bottom layer 30 a″ of flexible and elastic adhesive tape material.Bottom layer 30 a″ includes extending sections 30 a and a generallycentral opening 32 a″. Device 10 a further includes a top layer 20 a′ offlexible and elastic adhesive tape material (which can be the same typeof flexible and adhesive tape material used in bottom layer 30 a″). Toplayer 20 a′ includes an opening 22 a′. Top layer 20 a′ is overlayed uponfirst layer 30 a to form first section 20 a of device 10 a. Duringassembly, opening 22 a′ is aligned with opening 32 a″ to from opening 42a of device 10 a.

As illustrated in the embodiment of FIGS. 7A and 7B, devices 10, 10 a orother devices hereof may, for example, be provided in a kit 200including a plurality of such devices 10, 10 a within a packaging system100 (as known in the packaging arts). Devices hereof may, for example,be applied for a period of several days and then removed. For example,in a number of embodiments, devices hereof may remain on the child (oradult patient) for up to three days, and then will be reapplied after 24hours of non-use to allow the skin to breathe. A new device hereof maybe reapplied in this manner until closure of the hernia is achieved.

A good portion of umbilical hernias either require surgical closureafter the age of 3 or some will close on their own. The devices,systems, and methods hereof can promote umbilical hernia closure within30-60 days, if applied to a young infant. Older children will still seeimprovements, but such improvements may take longer. As described above,adults may benefit from use of the devices, systems, and method hereofin improving or preventing/limiting worsening of umbilical hernias. Thedevices, systems, and methods hereof provide parents and other userswith a safe, non-invasive way to help improve the outcomes of anumbilical hernia by muscle approximation and activation support, insignificantly less time than the traditional “wait and see” approachused with infants, while still promoting proper hygiene and breathingmechanics.

The foregoing description and accompanying drawings set forth a numberof representative embodiments at the present time. Variousmodifications, additions and alternative designs will, of course, becomeapparent to those skilled in the art in light of the foregoing teachingswithout departing from the scope hereof, which is indicated by thefollowing claims rather than by the foregoing description. All changesand variations that fall within the meaning and range of equivalency ofthe claims are to be embraced within their scope.

What is claimed is:
 1. A device for treatment of an umbilical hernia,comprising: a first section of flexible, elastic material comprising anadhesive layer on rearward side thereof, the first section comprising anopening therein dimensioned to encompass the umbilical, and a pluralityof extending sections of flexible, elastic material attached to andextending from the first section, each of the plurality of extendingsections comprising an adhesive layer on a rearward side thereof,wherein the first section is less elastic than each of the plurality ofextending sections.
 2. The device of claim 1 further comprising one ormore removable backing sections over the adhesive layer of the firstsection and the adhesive layer of each of the plurality of extendingsections.
 3. The device of claim 1 wherein a first plurality of theextending sections extend from a first side of the first section and asecond plurality of the extending sections extend from a second side ofthe first section.
 4. The device of claim 3 wherein the first pluralityof extending sections and the second plurality of extending sectionshave a maximum elongation in the range of 25 to 150%.
 5. The device ofclaim 3 wherein the first plurality of extending sections and the secondplurality of extending sections have a maximum elongation in the rangeof 25 to 100%.
 6. The device of claim 3 wherein the first plurality ofextending sections and the second plurality of extending sections have amaximum elongation in the range of 50 to 100%.
 7. The device of claim 1wherein the maximum elongation of the first section is in the range of15 to 85% less than the maximum elongation of the plurality of extendingsections.
 8. The device of claim 1 wherein the first section has athickness greater than each of the plurality of extending sections.
 9. Amethod of treating an umbilical hernia, comprising: providing apreassembled device comprising a first section of flexible, elasticmaterial comprising an adhesive layer on rearward side thereof, thefirst section comprising an opening therein dimensioned to encompass theumbilical, and a plurality of extending sections of flexible, elasticmaterial attached to and extending from the first section, each of theplurality of extending sections comprising an adhesive layer on arearward side thereof, wherein the first section is less elastic thaneach of the plurality of extending sections, wherein the first sectionof the preassembled device is applicable to the abdomen of an individualhaving the umbilical hernia via the adhesive layer and each of theplurality of extending sections is applicable to the abdomen via theadhesive layer.
 10. The method of claim 8, wherein the preassembleddevice includes one or more removable backing sections over the adhesivelayer of the first section and the adhesive layer of each of theplurality of extending sections, and the method further comprisesremoving the one or more removable backing sections over the adhesivelayer of the first section and over the plurality of extending sectionsbefore application of the first section and the plurality of extendingsections.
 11. The method of claim 8 wherein a first plurality of theextending sections extend from a first side of the first section and asecond plurality of the extending sections extend from a second side ofthe first section.
 12. The method of claim 11 wherein the firstplurality of extending sections and the second plurality of extendingsections have a maximum elongation in the range of 25 to 150%.
 13. Themethod of claim 11 wherein the first plurality of extending sections andthe second plurality of extending sections have a maximum elongation inthe range of 25 to 150%.
 14. The method of claim 11 wherein the firstplurality of extending sections and the second plurality of extendingsections have a maximum elongation in the range of 50 to 100%.
 15. Themethod of claim 8 wherein the maximum elongation of the first section isin the range of 15 to 85% less than the maximum elongation of theextending sections.
 16. A kit, comprising: a plurality of devices fortreatment of an umbilical hernia which are prefabricated forapplication, each of the devices comprising a first section of flexible,elastic material comprising an adhesive layer on rearward side thereof,the first section comprising an opening therein dimensioned to encompassthe umbilical, and a plurality of extending sections of flexible,elastic material attached to and extending from the first section, eachof the plurality of extending sections comprising an adhesive layer on arearward side thereof, wherein the first section is less elastic thaneach of the plurality of extending sections.
 17. The kit of claim 17wherein a first plurality of extending sections extend from a first sideof the first section and a second plurality of the extending sectionsextend from a second side of the first section.
 18. The kit of claim 17wherein each of the first plurality of extending sections and each ofthe second plurality of extending sections of each device has a maximumelongation in the range of 25 to 150%.
 19. The kit of claim 16 whereinthe maximum elongation of the first section is in the range of 15 to 85%less than the maximum elongation of the plurality of extending sections.20. The kit of claim 16 wherein the first section of each device has athickness greater than each of the plurality of extending sections.